The European Strategy for Tobacco Control (ESTC) reflects the increased political commitment to, and public health expectations of, tobacco control in WHO's European Region. It was adopted by the WHO Regional Committee for Europe at its fifty-second session in September 2002 and provides an evidence-based framework and guidance for effective national action and international cooperation. The ESTC builds on the lessons learnt from assessment of the three consecutive European Action Plans (1987-2001), the guiding principles set out in the Warsaw Declaration for a Tobacco-free Europe (February 2002), and the evidence underpinning tobacco control policy at national, regional and international level. The ESTC sets out strategic directions for action in the Region, to be carried out through national policies, legislation and action plans. It also makes recommendations regarding monitoring, evaluating and reporting on tobacco use and tobacco control policies. Finally, it specifies mechanisms, tools and a timeframe for international cooperation. The ESTC is an ongoing process, to be regularly reviewed and strategically adapted as appropriate